Gestational Diabetes in Pregnancy

Gestational Diabetes

Gestational Diabetes is defined as Diabetes occurring during pregnancy, that was not present prior to becoming pregnant. In our most recent podcast, we discuss gestational diabetes tips and gestational diabetes diet.  We also review what are the risk factors for gestational diabetes and how your baby can be affected by gestational diabetes.  Here is a quick review of what we cover, but be sure to listen to our podcast to get more information on all of these areas around gestational diabetes in pregnancy. 

If you want to create a birth plan get our free download here! 

The major hormone involved in diabetes is Insulin. 

During pregnancy, our tissues become less sensitive to insulin, which means our body needs to secrete more and more of it to have the same effect.

We don’t understand entirely why this happens in Pregnancy, but it is related to hormones produced by the placenta, and also partly by other pregnancy and obesity-related factors.

Gestational Diabetes happens when our pancreases can’t increase the amount of insulin needed to get all the sugar into our cells, so our blood sugar rises.

Our babies receive their nutrition through our placenta, and this includes sugar or glucose.  So if our sugar levels are high, our little babies have to increase the amount of insulin they produce to help manage those levels and get it all into their cells to store. Both the high levels of insulin and the fact that all of this extra glucose needs to be stored in the cell as fat means that babies grow bigger causing what we refer to as Macrosomia.

What are the risk factors for gestational diabetes?

Numbers vary from 3-20% of pregnancies affected by GDM - In Victoria last year approximately 15% of pregnant people were referred to the Gestational Diabetes Clinic.

Risk Factors include:

• Age 35 or older
• High-risk ethnic group
• Obesity
• Pre-diabetes
• Previous Gestational Diabetes
• Having had a baby weighing more than 4kg
• Parent or sister with Type 2 Diabetes
• Polycystic Ovarian Syndrome

How do we screen for it?

We generally check your blood sugar levels early in pregnancy and again at 24-28 weeks.

Is there any way to prevent it?

Lifestyle modifications can decrease the risk of at-risk pregnant people getting gestational diabetes from 18% down to 7%. This is a huge change compared to any medications we can use!

We have lots of tips in our podcast if you are interested in learning more about this! 

There are some supplements that look promising for decreasing the risk of getting diabetes as well!

How do we treat it?

As you can guess the treatment consists of a few things including dietary changes, exercise, blood glucose monitoring and medication if needed.

Check out our article with a dietician around tips and tricks for managing your diabetes with food. 

Monitoring your pregnancy:

We also keep a bit of a closer eye on your pregnancy if you have gestational diabetes.  If you are on medication, this monitoring is a bit more intense, but you should have an ultrasound at 36 weeks to see the size of baby and have a discussion with your care provider around induction of labour between 38-40 weeks of gestation. This is to decrease the risk of stillborn and the risk of cesarean section due to an ever-growing baby! 

In our prenatal course, we discuss in-depth monitoring of pregnancy and induction of labour if you want some more information. www.shefoundhealth.ca/masterclass

Post Partum:

• There is good evidence that breastfeeding your baby helps both your and your baby’s long term risk of diabetes and obesity.

• We recheck your blood sugars at 6 months postpartum and every 2-3 years. 

• We also now recognize that it also puts you at a higher risk for cardiovascular disease so it is important to discuss this with your care provider.

• Reduce your weight, targeting a normal body mass index in order to reduce your risk of gestational diabetes in the next pregnancy and developing type 2 diabetes down the road.

Resources:

https://www.diabetes.ca/en-CA/about-diabetes/gestational/gd-diet

https://www.healthlinkbc.ca/healthy-eating/gestational-diabetes